Your questions answered: A chat with the Minister for Families and Social Services Paul Fletcher

Last month we asked you what you most wanted to ask our pollies this federal election.

And we were flooded with questions – more than 200 in fact.

So we took the most common and we headed to Canberra to get some answers.

We booked interviews with Minister for Families and Social Services Paul Fletcher, Shadow Minister for Families and Social Services Linda Burney and Greens spokesperson on Disability Services Jordon Steele-John.

And keeping in the spirit of multi-partisanship we asked all three the same questions – so you could see and hear for yourself what the major parties have planned when it comes to the NDIS.

We will release each video over the coming weeks.

First up is Minister for Families and Social Services Paul Fletcher. We sat down with the Minister just after the budget – so in addition to your great questions we also had a chance to ask him a couple of things about the budget we thought you might like to know.

We recorded the whole interview here so you can watch it exactly how it went down – we have not made any edits, other than to tidy things up a bit (for example at the end of the video there was a problem with the camera that we had to fix). That’s so you can watch and make up your own mind.

Have a look and see what you think, then read on for our summary below:

Minister Fletcher mentioned a lot of things during this chat, so we’ve pulled together his main points below so you can get a quick overview.

1. What are you going to do to make the system more responsive and quicker?

“We want to get the first steps right because the plan is the absolute core of your NDIS experience,” said Minister Fletcher.

“We are working hard to improve the end-to-end process through things like the specialist participant pathways. We want to get people into the NDIS as quick as possible and onto their plans as quick as possible so they can start getting the supports that the NDIS provides.”

2. How can you make the system more flexible and more person friendly?

“We’ve done quite a lot of work to respond to this issue about how to make the NDIS more tailored to the individual experience,” said Minister Fletcher, who mentioned the introduction of specialist participant pathways including for kids and for people with complex needs or a psychosocial disability.

“I think the changes that we’ve made are very much about getting to the core of the problem, so that as people engage with the NDIS they feel they’re getting a caring response, but also a response that is based on an understanding of their circumstances.”

3. How will you ensure that there is adequate understanding of complex needs when assessing NDIS applications? What’s being done to provide LAC’s and planners with more training?

“We’ve got terrific staff in the NDIS, people drawn from a range of backgrounds… and there is a lot of work put in to the training process. The Agency has revamped the training process in the last few months,” Minister Fletcher said.

4. What can you do to make sure there is more consistency and fairness in the system?

“Consistency is important and it’s always going to be something that requires a lot of work when you have so many decisions to make,” said the Minister.

“It’s about training, experience, the organisation of the NDIA overall, and the Local Area Coordinators getting better at the job,” he continued. “What we don’t want to see is two people with virtually identical circumstances getting quite different plans. So we’ve done a lot of work standardising that… We’ve made significant progress there, but I’ll be the first to say there will always be an effort needed to achieve a consistency of plans.”

5. When will the NDIS adequately fund transport so participants can actually use their funded community access?

“As you know there are three levels of transport funding that are typically included in a plan,” the Minister said.

“There is also some scope for flexibility particularly when you’re self-managed. And inevitably we find out a bit from experience … what’s the optimal mix?

“It’s a bit of learning by doing.

“The states and territories have a significant role here as the providers of public transport … Some of this is very much within the spectrum of the NDIS and some of it goes beyond.”

6. Why are second and subsequent plans are being cut? What are you going to do to make sure the NDIS is fair?

“I know this is an issue that people raise quite often with me and my colleagues,” said Minister Fletcher.

“If you look at the overall numbers what it shows is that 37% of plans at the moment are increasing on the previous level of the plan and a little under one third are the same. A little under one third are declining. So there’s no overall pattern of total dollars going into a plan reducing – in fact to the contrary.

“The underlying issue is making sure the plans are consistent across people in the same circumstances, and the plans are appropriate to meet the needs of an NDIS participant.”

7. What are you going to do to make sure unpaid carers get the support they need so they can keep providing care?

“The role of families and carers in the lives of people with disabilities… is critical and it’s a very tough job,” said the Minister.

“We did announce in this year’s Budget $84 million of additional funding for carers… which takes funding to over $500 million, which includes funding for additional respite opportunities.”

8. What do you plan to do about creating more housing for people with disability?

“It’s certainly been something that’s been a significant focus for me since I’ve been in the portfolio,” said Minister Fletcher. “At the moment there’s around 11,000 people that are supported through Specialist Disability Accommodation. That’ll reach about 28,000 when we get to full scheme.”

“The level of interest in providing specialist disability accommodation is strong and growing,” he said. “Our commitment is that if you are in residential aged care now and you want to move out into the community we’ll commit that if you’re under 45, that’ll be available to you by 2022. And for anybody under 65 that’ll be available for you by 2025… It’s not a one time way to address this problem, we’ve also said by 2025 we want to reduce the number of young people going into aged care by 50% as well.”

9. What are you going to do to make sure the people who aren’t eligible for the NDIS get the support they need?

“We’ve got a National Disability Strategy that we’ve kicked off some early work on,” said Minister Fletcher.

“There are existing programs, existing Commonwealth programs and State and Territory programs for people who aren’t eligible for the NDIS but clearly need to continue to be supported. So we’ve got a continuing program to support those people.”

10. Why is it that advocacy is so poorly supported and what will you do to address it?

“There is in fact quite significant Commonwealth support for advocacy because it is important,” said the Minister. “We have announced some increases [to advocacy funding]. Advocacy funding is important because we recognise it’s an important part of the overall process.”

11. Why isn’t it possible to invest the NDIS underspend back into the scheme to get it working the way we all want it to?

“You can have confidence that the Scheme will continue to be fully funded and the supports you need to get funded once you get your plan, the money is there,” said Minister Fletcher.

“So people in the scheme and people aiming to get into the scheme should have confidence. There is a lot of money being spent. It’s going up every year and we continue to be on track to achieve 460,000 people.”

Transcript

KIRSTEN DEANE: So, thank you very much, Minister, for agreeing to speak to us, particularly at such a busy time.

We really do appreciate it.

MINISTER PAUL FLETCHER: Pleasure, it’s good to be with you.

KIRSTEN: We put out a call to our Every Australian Counts community asking what did they want to ask the politicians in the lead up to the federal election, and we got more than 200 questions.

So, you’ll be pleased to know we’re not going to ask you all of them, what we’ve done is gone through them and tried to pick the ones that are most common.

So that’s what we’re going to ask you here this morning.

So, I have to say, a lot of people asked a version of this question but we’ve picked the one from Natasha that really sums up so many.

Why is everything taking so long?

Why am I so far removed from the people making decisions?

And what do I have to keep jumping through so many hoops?

What are you going to do to make the system more responsive and quicker?

MINISTER: Well, if we keep a very close eye on what people’s experience is as they come into the scheme, so how long access decision takes, how long it takes for you be told, “Yes, you’re covered by the NDIS” or “No, that your degree of functional impairment is not sufficient for you to be covered.”

And on average, the people coming across from an existing state service, bearing in mind that historically people of course have been served by the states and territories.

That’s a one day process to get an access decision, across the total population, about nine days, of course then we go to the plan, developing the plan so you’ll be engaging with your Local Area Coordinator working though the different elements of that.

On average, that’s taking about 90 days.

Now, it is important that we take the time to get that right ’cause obviously the plan is the absolute core of your NDIS experience.

It’s important to make the point that of course, in the areas that are coming online for NDIS as we continue to transition from the state systems, you can apply up to six months before.

So you can get in the queue as it were, to try and reduce the end to end time.

So look, we are working hard to improve that end to end process.

Things like the Specialist Participant Pathways and so on.

Because we are conscious and of course, we want to get people into the NDIS as quickly as possible and to get their plans sorted as quickly as possible so you can start getting the supports that the NDIS provides.

KIRSTEN: Alright, so the next question that we have is from David.

And that’s related.

How can you make the system more flexible and more person-friendly?

It’s very rigid and bureaucratic.

MINISTER: And again, we’ve done quite a lot of work to respond to this issue about how do we make it more tailored to the individual experience?

So, some of the specialist pathways that have been introduced; Early Childhood Early Intervention, of course, with the child who’s on the autism spectrum or a child with a hearing impairment.

It’s so important that we can get them receiving the supports as quickly as possible, because of the life-long benefits that can be delivered if we can get somebody supported as quick as possible, particularly a child.

Things like the psychosocial disability pathway for people with very serious mental illnesses.

The complex needs pathway and so on.

Are all about making the experience more tailored to the circumstances of individuals.

I do occasionally hear instances of things being said in the planning process which don’t show the level of familiarity that we would like to see being demonstrated with the particular disability that somebody has.

I think the changes that we’ve made are very much about getting to the core of that problem, so that as people engage with the NDIS, they feel they’re getting a caring response, but also a response that is based on an understanding of their circumstances.

INTERVIEWER: Well, actually that leads nicely into sort of two questions that we have from Dominique and Jen which is: How will you ensure that there is adequate understanding of complex needs when assessing NDIS applications?

How can you make sure that those assessing and approving plans are properly qualified and have the relevant experience?

And what’s being done to ensure there’s more comprehensive training for LACs and planners.

MINISTER: It does come to that point about making sure that the people who are dealing with somebody who comes into the scheme or someone who’s in the scheme, has an understanding of the particular circumstances, the particular disability that somebody has.

Of course, we’ve got terrific staff in the NDIS, people drawn from a range of backgrounds, allied health professionals, people with a mental health background, a whole range of backgrounds.

There is a lot of work put into the training process and we’ve revamped, the Agency’s revamped the training process just in the last few months.

Of course, I’m talking here about both people within the Agency and then the Local Area Coordinators, in total there is more than 10,000 people working to support people in the NDIS so, a very large scale exercise.

The intention with the specific pathways is to be more tailored and have a degree of specialisation there.

And back that up with appropriate training.

KIRSTEN: So the next question that we have is from Ruth.

What can you do to make sure there’s more consistency and fairness in the system?

At the moment, plans seem to be a bit hit and miss.

MINISTER: It is a very important point because we’re now at over 250,000 participants, of course we’ll be at 460,000 at full scheme.

That’s a huge number of decisions or sets of decisions being made about what somebody gets in their plan.

What kind of therapies are included in the plan?

What assistive technology is included in the plan?

And of course, with the explosion in technology, that’s a very complex question in itself and there’s some wonderful technology available.

How do we get consistency in terms of what goes into a plan for say somebody who’s vision impaired, technology to assist them to all the various things to help turn something into… something written into something that they can hear and so on.

Or, wheelchair technology.

So, consistency is important and it’s always going to be something that requires a lot of work when you’ve got so many decisions being made.

Of course, it’s important that we’ve got the internal review process.

And on top of that, the appeal process to the AAT.

We do… it is important to have those steps in there, I’m conscious there’s some stress involved, if you end up going down that path, it’s very important to have that internal review and to have the process of appealing to the AAT.

Under the Act, planned decisions must be made by a delegate of the Chief Executive, so an employee of the NDIA.

And we obviously have some extensive mechanisms as to the frameworks within which they operate.

But it’s also about training, experience, and the organisation, the NDIA overall and the LACs getting better at the job.

KIRSTEN: So people don’t end up having to… at review.

MINISTER: Indeed, and what we also don’t want to see is two people with… virtually identical circumstances, getting quite different plans.

And so there’s a lot of work on standardising that, that’s important for a whole range of reasons.

Fairness, equity, also cost effectiveness.

So, we have I think, made some significant progress there but I’ll be the first to say there will always be an effort needed to achieve a consistency of plans so that two people with the same disability, same circumstances, are getting broadly the same plan.

KIRSTEN: This question was sent in by Diane, but actually, it comes up many times in the Make It Work forums that we hold around the country.

When will the NDIS adequately fund transport so participants can actually use their funded community access?

MINISTER: As you know, there are three levels of transport funding that’s typically included in the plan.

Ranging from in the order of $1,200 at one end to $3,000 or so.

And then the range of options included in the plan, it can be at one end, assistance and support in using public transport.

Which… say for somebody with an intellectual disability or of course, a physical disability.

There can be a range of challenges there.

Also, some very good success stories I’ve heard about for example, of people with intellectual disability who master that challenge and have more autonomy and control over their life as a result.

So, in transport, there is that specific allocation for transport.

I think there’s also some scope for flexibility particularly when you’re self-managed in terms of your basic supports.

And inevitably, we find out a bit from experience, and a participant finds out a bit from experience, what’s the optimal mix?

How much transport do you need so that… I think the principle is very well understood that unless you can get to, where the supports are provided, unless you can get to the place where you’re doing your interaction with the community.

Whether that might be a class or the gym or anything like that, exercise, then, unless you can get there, you can’t really use the support.

So, that principle, I think is very clear and well understood.

The specifics of what that means in terms of the dollars to be spent on transport versus the other elements of the plan, necessarily… even at the individual participant level, it’s a bit of learning by doing.

It’s OK, what’s the balance here?

I think the other thing I’d say is that there is a… the states and territories have a significant role here.

Including of course, as the providers of general public transport, as the regulators of most transport delivery mechanisms including, you know, taxis and so on, Uber and so on.

So, I think it’s… some of this very much within the spectrum of NDIS, some of it goes beyond.

KIRSTEN: To the National Disability Strategy?

MINISTER: Well, indeed.

The issues about whether stations are accessible for people with disability.

KIRSTEN: Alright, this was again, a common question but we’ve chosen the one from Fiona.

Why are second and subsequent plans being cut?

We were building up a good program, with excellent goals for the future independence of our son, when his funding was cut drastically.

So now, we can’t meet his goals.

What are you going to do to make sure the NDIS is fair?

MINISTER: I know this is an issue that people raise quite often with me and with my colleagues, and they raise it with me.

And it’s understandable that if you’ve been given a plan for one year, which might be for $40,000 and the next year, the plan’s for $15,000.

At first blush, that seems like a very significant reversal.

Of course, quite often what will happen is the first plan will have major capital items, like a wheelchair, it might cost 15 or $20,000 or more.

Or a hoist or other technology, so that’s certainly one factor.

If you look at the overall numbers, what that shows is 37% of plans at the moment are increasing on the previous level of the plan and a little under 1/3 are the same, a little under 1/3 are declining.

So there’s no overall pattern of the total dollars going into a plan reducing in fact slightly to the contrary.

I think it’s really, again, the underlying issue is making sure that the plans are consistent across people in the same circumstances.

And that the plans are appropriate to meet the needs of the NDIS participant.

That’s why we do have the review processes.

And where there are anomalous decisions made, and inevitably, there will be, in an organisation, a program of this scale, we try to minimise them, but where there are, then those review processes are important to highlight if there are particular anomalies that need to be fixed.

KIRSTEN: Alright.

Again, we had this question from a number of people but we’ve picked the one from Pam.

While many people with disability who receive support from the NDIS, won’t need any help from families and unpaid carers, many others will.

We know that many families are really struggling.

What are you gonna do to make sure they get the support they need and they can keep providing that care?

MINISTER: I think Pam raises a very important question.

Of course the role of families of carers in the lives of somebody with disability and particularly somebody with disability which involves a very significant functional impairment.

The role of families, role of carers is critical.

And it’s a very tough job.

And it’s a job that… you haven’t asked for.

It’s the hand of fate that has given you that job.

And I do wanna say how impressed I am by the love that is shown by carers all around Australia in caring for people with significant disability and the caring for people with a whole range of other circumstances as well.

Now, we did announce in this year’s budget, 84 million dollars of additional funding for carers.

That takes our total funding adding on to what’s been announced in previous years to over 500 million dollars.

Included in that is therefore funding for additional respite opportunities.

And it also fits in with other resources for carers, a website and places where people can go to just get some advice, get some help to download on the challenges that being a carer can bring.

In particular, that 84 million dollars of funding I think will mean that there’ll be some tangible instances, quite a few in fact where people can get the opportunity to get a bit of relief and support in circumstances where that might be… where the funding hadn’t previously been there.

INTERVIEWER: So, question from Robert.

What do you plan to do about creating more housing for people with disability?

MINISTER: Robert’s raised a great question, ’cause that’s certainly been something that’s been a significant focus for me since I’ve been in the portfolio building on the great work of my predecessors.

So Specialist Disability Accommodation, at the moment, there’s around 11,000 people who are supported through Specialist Disability Accommodation.

That will reach about 28,000 when we get to full scheme.

And I had the opportunity to go to a development created by Summer Housing.

And see an apartment there with widened doorways, disability suitable bathroom, a hoist in the bedroom, lowered cook tops so that if you’re in a wheelchair you can reach the taps and the knobs on the cooker and so on.

Actually, the thing that struck me the most about that was the technology.

So, with… by pressing a smartphone, you can open and close the curtains, lock the doors, unlock the doors, turn on the air-conditioning and so on.

And of course, if you’ve got a disability, that technology can make a difference between living independently or not.

So, there’s some very exciting progress being made in Specialist Disability Accommodation.

And we’ve done a lot of work in working with potential investors to make sure we’ve got the right framework there to encourage the investors to come in to the
market.

Because what that will do is they’ll take the financial risk on designing and building the property.

And then, based upon the regulatory framework, they can have a degree of confidence that they’ll get the payment stream to support somebody with significant disability living in that specially designed accommodation.

And that work that we’ve done has, I think, helped increased the confidence in the sector and the level of interest in providing Specialist Disability Accommodation is strong and growing.

So, we’ve also announced a specific plan for young people in residential age care.

As you know, there’s around 6,000 people around Australia in residential age care who are under 65 and they’re there because they’ve got significant disability and that’s about the only place where they can get appropriate care at the moment, but it’s not really optimal if your… Aged care facilities are designed to support older people and they do a great job.

If you’re 45 or 25, you don’t really want to be sharing accommodation with people who are two or three generations older than you.

So, our commitment is that of those people who are residential aged care now, if you want to move out into the community, we’ll commit, but if you’re only 45, that’ll be available to you by the time… by 2022.

And for anybody 65 and under, or under 65, that’ll be available to you by 2025.

So that’s quite a lot of people we’ve got to move, it’s quite a significant commitment, it can only be made because of the work we’ve done with Specialist Disability Accommodation.

The level of confidence we now have that the investment is coming into the market.

So the stock of Specialist Disability Accommodation is going to increase quite significantly over the next few years.

And we’ve also said we want to continue then to maintain that… for the future that, it’s not a one time way to address this problem, we’ve also said that from 2025, the number of younger people coming in to aged care, we want to be reduced by 50% from where it is now.

KIRSTEN: Alright, we have a question from Sarah.

What are you going to do to make sure that people who are not eligible for the NDIS still get the support they need?

MINISTER: Well, that is important because the focus on the National Disability Insurance Scheme is perfectly understandable.

It’s a huge scheme, it’s the biggest change in social policy for more than 30 years.

And therefore, it’s taken a lot of focus to make sure that we are rolling it out.

Of course, no roll out is ever perfect.

But the scale of what’s been achieved since 2016, we’ve increased by 700%, the number of people who are in the scheme.

And there’s more to do.

But at the same time, obviously, we’ve got a National Disability Strategy that has to be developed, the next stage of that.

And that’s certainly something that we’re mindful of and kicking off some early work on.

KIRSTEN: And you’re doing some consultations on that?

MINISTER: We are, indeed, yes.

And, so that is certainly an important part of the picture.

We’re also conscious that there are existing programs, existing Commonwealth programs and state and territory programs supporting people with disability who don’t meet the degree of functional impairment required to be eligible for the NDIS, but clearly need to continue to be supported.

So, we’ve got a continuing program to support people in that category under the various Commonwealth programs.

And similarly the state and territory governments have continuing responsibilities in relation to people who are being supported now but don’t meet the threshold for NDIS.

KIRSTEN: Alright, we’ll give the final question to David.

Advocacy is essential for fair and adequate planning.

If clients are to gain the full benefits of the NDIS.

So why is it that advocacy is so poorly supported?

And what will you do to address it?

MINISTER: Look, there is in fact quite significant Commonwealth support for advocacy because it is important.

And for example, if you are going to appeal at the AAT, the Administrative Appeals Tribunal.

You will often need some help in doing that, assuming you’re not in your day job, you know, an administrative lawyer.

Which I can only assume a majority of people are not.

So, there is funding for that and there’s funding to support some of the other advocacy roles, including some of the work that the peak bodies do and so on.

Look, I understand that people will… always be making the case for, can we have some additional funding?

I understand that, and we have announced some increases, I understand they, the people, would always want to see more funding, but advocacy funding is important, there is ongoing funding for advocacy because we recognise that it’s an important
part of the overall process.

KIRSTEN: So Minister, given that we are here for the budget this week, we do have one question.

The NDIS has been underspent for many years now.

So, why isn’t it possible to invest some of that money back into the scheme to get it working the way we all want it to?

MINISTER: Look, it’s an important question ’cause there’s been a bit of a misunderstanding that’s emerged this week about what the budgetary treatment of the National Disability Insurance Scheme is.

The starting point is that back in 2012/13.

The states and the territories and the Commonwealth agreed on so-called bilateral estimates.

When you roll that up to a national number, that’s that 460,000 target that we talk about quite often, that we are on track to get to by 2020.

And there was an expected pathway, so a number of people in the scheme to rise from 2012, 13, through the 2020.

As we’ve gone through that trajectory, we’ve made variations up and down in what we budgeted for it.

And that’s a perfectly routine thing that happens in the budget process, not just in disability but in health, in other parts of my portfolio.

In what we budget for Newstart, or what we budget for age pension, you make variations year by year depending upon what the underlying numbers are of people who will be funded.

So, for example, a couple of years ago, we made some significant upward variations once WA came into the scheme, or we’d reached agreement with WA.

To make sure that we were reflecting those additional participant numbers.

So those ups and downs occur all the time.

What’s happened this year, so in 2019/20, we made a net variation of $1.6 billion.

And that essentially reflects that we’re a little behind in terms of the participant numbers for the 19/20 year compared to where a few years ago, we thought we would be.

Very importantly, we have not changed where we expect to get to, so we still expect to be at 460,000 by 2020, and we’re still very focused on getting as many people who are eligible for the scheme into the scheme as possible.

But that $1.6 billion is essentially, it’s the application of normal budgeting practise.

You say OK, how many people this time last year were we thinking we’d have in 19/20.

OK it’s now a bit less, so as we do the budget for this year, we adjust downward slightly the amount that we’ve got in the budget.

It’s important to make the point that in 2019/20, we’ll spend $17.9 billion on the NDIS.

That’s $4.5 billion more than in 18/19.

So, people in the scheme and people aiming to get into the scheme should have confidence.

There’s a lot of money being spent.

It’s going up every year.

We continue to be on track to achieve 460,000 people and you can have confidence that the scheme is fully funded and that the supports that you need to have funded once you get your plan, what’s there, the money is there.

And I’ll make one other point… over the weekend I announced $850 million dollars in additional spending in 19/20 under the NDIS.

So that’s for all the existing participants.

And that reflects the fact that we’ve increased the pricing levels that the National Disability Insurance Agency will allow in respect of all of the supports that are provided.

So the hourly rate for a personal care worker.

Or the rate for a physiotherapist, or an occupational therapist or a psychologist, any of the health and allied health professionals who you’re engaging with in receiving your supports, we’ve increased the pricing in some cases by up to 15.4%.

That’s about making sure that the supports are there, that the providers are properly incented to come in and provide those supports across the whole scheme, that’s an additional $850 million dollars of financial commitment for 19/20.

It’s very important that when we increase the prices, we also increase the amount that is in people’s plans so the plans will be automatically indexed to take account of those price increases.

So my point is, we’ve got a variation as a result of the numbers in the scheme being a little less, the number of participants being a little less as at 1 July 2019 than we thought they would be a few years ago.

As the numbers go up, the money’s there.

If the numbers… if there was an unexpected upward variation, we will fund it.

Just as for example, in this year’s budget for public hospitals, there’s a $1.9 billion dollar upward variation across the four years because of more places in public hospitals that we need to fund.

These are demand-driven programs and you vary the numbers in the budget every six months.

The budget and a halfway point, the so-called MYEFO – Mid Year Economic and Fiscal Outlook.

And you do that to make sure that what you’ve got in the budget is based upon your best understanding of the demand levels and that you’ve got the money there to meet the demand.

We’re very confident we’ve got the money there to meet the demand and we remain…

KIRSTEN: People will be very pleased to hear that.

MINISTER: And we remain on track for the 460,000 participants.

And by the way, the money doesn’t stop there.

The NDIS is a permanent feature of the Australian social policy landscape and naturally, with a growing population, we expect the numbers in the scheme will continue to grow over time.

But the 460,000 is what’s being set as the goal, the bilateral estimate rolled up from the numbers agreed between the Commonwealth and each state and territory.

Where we expect to get to. We’re on track to get there by 2020 and the money is there in the budget to meet that level of demand.

KIRSTEN: Good, thank you.

As I said, Minister, we really, really appreciate your time this morning.

And we thought you might like one of our T-shirts to be an honorary member of the Every Australian Counts community.